Individual
HENRY DUNNENBERGER IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-3119
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051297655
IL
183500000X
Pharmacist
22699
NC
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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